Loss to Follow-Up and Social Background in an Inception Cohort of Patients With Severe Traumatic Brain Injury: Results From the PariS-TBI Study.

J Head Trauma Rehabil

APHP-Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, Garches, France (Drs Jourdan, Ruet, Vallat-Azouvi, and Azouvi); EA 4047 ECIPSY, Université de Versailles Saint Quentin, Saint-Quentin, France (Drs Jourdan, Bahrami, Ruet, and Azouvi); Université Paris-Dauphine, Laboratoire d'Économie et de Gestion des Organisations de Santé (LEDa-LEGOS), Paris, France (Dr Bayen); Université Pierre et Marie Curie, Paris, France (Drs Bayen and Pradat-Diehl); APHP-Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Médecine Physique et de Réadaptation, Paris, France (Drs Bayen and Pradat-Diehl); APHP-Hôpital Raymond Poincaré, Unité de Santé Publique and CIC-IT 805 Inserm, Garches, France (Dr Bahrami); APHP-Hôpital Ambroise Paré, Unité de Recherche Clinique (URC), Boulogne, France (Mr Ghout and Mrs Darnoux, Drs Azerad and Aegerter); Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France (Mrs Darnoux, Drs Azerad and Weiss); Antenne UEROS-SAMSAH92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France (Dr Vallat-Azouvi); APHP-Hôpital Lariboisière, Département d'Anesthésiologie, Soins intensifs & SAMU, Paris, France (Dr Mateo); APHP-Hôpital Bicêtre, Département d'Anesthésiologie & Soins intensifs, Le Kremlin Bicêtre, France (Dr Vigue); and SAMU 77, Mobile Care Unit, Hôpital Marc Jacquet, Melun, France (Dr Tazarourte).

Published: March 2018

Objectives: To assess determinants of loss to follow-up (FU) at 2 time points of an inception traumatic brain injury (TBI) cohort.

Design And Participants: The PariS-TBI study consecutively included 504 adults with severe TBI on the accident scene (76% male, mean age 42 years, mean Glasgow Coma Scale 5). No exclusion criteria were used.

Main Measure: Loss to FU at 1 and 4 years was defined among survivors as having no outcome data other than survival status.

Results: Among 257 1-year survivors, 118 (47%) were lost to FU at 1 year and 98 (40%) at 4 years. Main reasons for loss to FU were impossibility to achieve contact (109 at 1 year, 52 at 4 years) and refusal to participate (respectively 5 and 24). At 1 year, individuals not working preinjury or with nonaccidental traumas were more often lost to FU in univariate and multivariable analyses. At 4 years, loss to FU was significantly associated with preinjury alcohol abuse and unemployment. Relationship with injury severity was not significant.

Conclusions: Socially disadvantaged persons are underrepresented in TBI outcome research. It could result in overestimation of outcome and biased estimates of sociodemographic characteristics' effects. These persons, particularly unemployed individuals, require special attention in clinical practice.

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http://dx.doi.org/10.1097/HTR.0000000000000147DOI Listing

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